The Chronic Obstructive Pulmonary disease (COPD) is one of the main causes of morbidity and mortality worldwide. It is commonly described as a “preventable and treatable disease characterized by a progressive and persistent airflow limitation that is not fully reversible”.
The airflow limitation in COPD is irreversible owing to structural changes in the lungs, including chronic bronchiolitis and emphysema. The main consequence is premature mortality.
COPD is caused by log-term tobacco smoking and environmental factors (air pollution, dust, particulates or toxic fumes).
Although people affected by COPD develop common respiratory symptoms, the disease is frequently under-diagnosed and under-treated. The result is a late diagnosis, consequently interventions are less effective, and co-morbidities are more frequently, resulting in a reduced life expectancy accompanied by a poor quality of life and frequently hospitalizations.
The optimal COPD management is based on the removal of risk factors, symptoms relief, improvement of quality of life and reduction of mortality. Most often, treatments of COPD are bronchodilators, pulmonary rehabilitation, corticosteroids, oxygen therapy and surgical approaches (Lung Volume Reduction (LVRS) and lung transplantation) for most advanced COPD.
Despite LVRS enhances health-related quality of life, in selected patients with advanced emphysema, it is associated with a high operative mortality, morbidity rate and long hospitalization. Therefore, minimally invasive techniques have been proposed for the treatment of COPD patients with emphysema. In particular, it has been shown that the Bronchoscopic Lung Volume Reduction Surgery (BLVR) provides the same clinical and functional advantages of LVRS thus reducing risks, mortality and costs.
Current evidences suggest that not all classes and phenotypes of emphysema will benefit from BLVR, and the application of a specific technique appear to provide a greater benefit to specific sub-groups of patients; for this reason a careful patients selection is mandatory.
The BreathGroup is a network of selected Centers performing Bronchoscopic Treatments of Emphysema, with primary aims:
- to institute a web Register designed to collect, revise and analyze all patients undergoing Bronchoscopic Treatment of Emphysema
- to adequate patients’ selection to the European standards and treat them according to the International standardized “best practice” guaranteeing patients safety
- to evaluate patient reported outcomes (PROMs) after BLVR, in order to advance the understanding of the characteristics of patients in whom the different treatments result in the best outcomes. According to these considerations, it could be possible to personalize the best bronchoscopic treatment of emphysema according to patients’ characteristics.